Frequently Asked Dental Questions – Rowley, MA

Are silver fillings, fluoride, or x-rays a danger to my health? What are the alternatives?

Let me say first of all that the best dentistry is NO dentistry! Perfection is a tooth without decay or disease. The best we know how to restore them is, at best, a distant second compared to God’s handiwork. So, we focus on prevention with regular maintenance appointments, dietary and supplement coaching, and particular attention to homecare regimens that are proven in the literature.

When we must restore teeth, we use the longest-lasting, most biocompatible restorative materials currently known to the profession. “Amalgam,” by definition, is a mixture of a metal with mercury.

Silver amalgam is a common restorative material in dental offices in the U.S. We don’t feel that mercury is a good idea in anyone’s mouth. The literature gave me enough concern about mercury in fillings that I chose to discontinue its use in 1999. We simply don’t offer it in this dental office, because we don’t see it as a healthy service. In addition, silver amalgam has very low crushing strength, so after a few years, it begins to expand in the center of the tooth and ultimately causes cracks in the surrounding tooth structure resulting in broken, cracked, and sensitive teeth.

Fluoride is judiciously used topically with people that seem to be caries-prone. Sometimes people can become more caries-prone when taking certain medications that dry the mouth. Dietary habits with hidden sugars can also cause decay. We do not advocate the systemic use of fluoride, simply because it is a VERY active ion and attaches to many chemical reactions in the body that may not necessarily be beneficial to your systemic health.

X-rays are a necessary modality to see disease processes within the teeth, in bone and beneath the surface of the gums. We are acutely aware of people’s concerns about radiation. For that reason, we made a considerable capital investment to convert to all-digital x-ray equipment, thereby reducing radiation exposure 85%-90%. The use of digital radiography also has a positive environmental impact, as we no longer require the use of darkroom chemicals to process film.

My gums bleed after I brush. If my gums bleed when I brush, is that considered normal?

Would you think it was normal for your hands to bleed when you washed them? Of course not! If the gums are bleeding, they need some personal and professional help to grow new skin back on them. That way, the skin keeps the blood in and the bacteria out!! Our dental hygiene department’s goal in life is to have their patients in the maximum health and comfort that is personally attainable. The key is to teach patients how to maintain that level with a personalized program of homecare and regular professional maintenance.

I really do not like visiting the dentist. Is there anything you can do to help me relax?

Please visit the sedation section of our website.

How does Dr. St. Clair keep up to date with all the current techniques and materials?

The state of Massachusetts requires 40 hours of continuing education per two-year licensure renewal period for dentists. Dr. St. Clair belongs to two professional study clubs, at least 4 or more professional organizations and averages 75-100 hours per year in continuing education, both in lecture and hands-on formats. He has invested hundreds of thousands of dollars on education after dental school.

Do you accept referrals?

We are almost exclusively a referral dental office, built upon the kind referrals of our existing clients. If you have read this far into this website, you are merely a stranger who is not a friend yet!

Do you accept my insurance plan?

At this time, Dr. St. Clair is happy to accept Delta Dental, Blue Cross/Blue Shield as well as plans that do not require you to pick a dentist from a predetermined list. At the end of the day, insurance companies are more focused on ensuring shareholders profit, rather than helping you address your dental needs. As a result, dentists who are members of low-cost HMO/PPO plans are forced to cut down on costs, and that often ends up negatively affecting the consumer. When you call our dental office, we’ll make sure that the process of using insurance is as simple and straightforward as possible.

Click below to read newspaper columns Dr. St. Clair has written on dental insurance.

Dental Insurance #1 Dental Insurance #2

What do I do if I have an emergency when the dental office is closed?

Dr. St. Clair can always be reached on his cell phone (978) 771-2638. If Dr. St. Clair is away for any reason, a doctor on call, whom he knows personally, will be available.

I have a temporary crown in my mouth. What happens if it comes off or breaks?

If the temporary comes off, it is rather important to get it back on in order to hold the proper relationship for the new restoration. There is a commercial product available in pharmacies, called DenTemp that can be used in an emergency. Also, in a pinch, a little denture adhesive will hold the cap on for several days. If the temporary breaks and there are no symptoms with the tooth, it should be re-made and re-cemented on the next business day, if possible. If the tooth is uncomfortable, call Dr. St. Clair on his cell phone at (978) 771-2638.

What different payment options do you provide?

Please see the financial section of our website.

How can I ask Dr. St. Clair questions directly?

Dr. St. Clair will make timely responses by e-mail or phone. His e-mail address is jpstclair@stclairdmd.com. If you need to consult with him regarding treatment options that you are considering, please call the dental office to schedule a no-charge second opinion visit.

I don’t like drills. Are there any other options?

Your other options, which are not currently available in this dental office, are air-abrasion technology or hard-tissue lasers. These are not available in our dental office because, after careful research at this point in time, there is not significant time savings for the patient to warrant the capital investment required. We feel dental patients don’t want to be in the dental office any longer than is absolutely necessary, so we are able to perform these services in less elapsed time with conventional means at this moment.

How do I know when it is time for a checkup?

Most adults require bi-annual to quarterly visits to maintain optimum periodontal health and longevity. We tailor our re-care visits to your unique conditions.

Do I have to floss every day? Is it really important?

You don’t have to floss all your teeth, just the ones you want to keep!

What precautions do you take to ensure patient safety?

We use heat sterilization and disposable barriers on everything that comes into contact with patients in the treatment environment. We use protective eyewear all around. In addition, we use high power magnification to provide better vision and precision to dental procedures.

What about my children? At what age should they see a dentist? What’s your philosophy on treating children?

We love kids! Unless a parent sees something unusual, we recommend seeing children at the age of 3 for the first time. If treatment is needed that is beyond the scope of our dental office, a referral will be given to a pediatric dentist. We rarely find the need to refer kids.

I’m taking my child to a pediatric dentist. When do we make the change back to a general dental office?

I like to see kids switch around the age of 10 or so because I like to be a part of the decision-making process of orthodontics.

What if I need to cancel an appointment?

Out of respect for the doctor’s time and our other patients’ time, we ask that you make every effort to give us at least 48 hours’ notice, particularly if you have reserved a large block of time for major treatment. We are, however, cognizant that it is not always possible, and family or personal emergencies do occur. Please leave a message on our message center, or if it is less than 24 hours’ notice, call the doctor’s emergency line, so we are able to give your time to someone who can use it.

How did you choose dentistry as a career?

I grew up in both Long Island and Connecticut. My father, still a practicing veterinarian with my brother, used to take me to his dental office every weekend. Being the oldest of three, my job was to clean-out dog cages. I think that is the reason I am not a veterinarian today. I do have two dogs though.

My parents were big on education. I went to private school just about my whole life….could be why my kids are in public school. Anyway, I got a terrific high school education at a boarding school called Avon Old Farms, which I did not fully appreciate until later in life. If you have not heard of or seen the architecture of this school, you should check out the website www.avonoldfarms.com. From there I went to St. Anselm College in Manchester New Hampshire, my father’s alma-mater. I loved science and decided to be a biology major. I played on the golf team my first year but quickly realized I couldn’t do both……and there was no chance of me becoming a golf pro. For two years during the summers, I landed a great internship at Bristol Myers-Squibb. I learned a lot, including that I didn’t want to do research my whole life. As I approached my senior year, I realized that college was going to be coming to an end and I had to choose something to do with my life. I instantly thought medicine. I worked nights at a local emergency room and loved it. However, I wasn’t sure that I wanted the hours that I saw many physicians had. My girlfriend’s (now my wife) mother at the time brought up dentistry. I thought – teeth? – that’s like looking at feet all day. I looked into it and decided to apply. The first school I got into was Tufts and I decided to go. So, no, I did not want to be a dentist my whole life. It was a last minute decision. I love what I do. Every once in a while, I think about what it would be like doing something else. If I could do it all over again, I would still be a dentist.

I like medicine, so I’m curious about my patients’ total health, as the mouth is often the indicator of their general health. I read a lot of medical/dental type stuff. It’s been my privilege to render early diagnoses of and qualified referrals for a number of my patients, intercepting some significant medical conditions. In doing my research, I’ve discovered it’s a whole lot easier to stay well, than it is to get well, so you’ll find we stress prevention and personal responsibility a lot in this dental office. Over the years, I’ve found there is nothing I can do, no service I can perform, no material I can use, no high-tech gadget I can employ, that will overcome what a patient will NOT do with diet and home care. On top of that, medicine and dentistry as they are currently practiced are far more attuned to treating illness and disease than reversing or curing it. That, unfortunately, is the unhappy truth.